A Study Of Beck's Cognitive Theory Of Depression In The Context Of Chinese Culture

STEDY-1ObjectiveTo explore the reliability and validity of the Chinese-version Cognitive Distortions Questionnaire(CDQ)in depressed patients in China.MethodsA total of 347 patients with depression were recruited in the study.Sample 1including 145 depressed patients was tested for item analysis and exploratory factor analysis,and sample 2 including 202 depressed patients was tested for confirmatory factor analysis.All samples were analyzed for internal consistency reliability.The criterion validity was tested with Dysfunctional attitude scale(DAS),Negative automatic thoughts questionnaire(ATQ),and Beck depression inventory-?(BDI-?).Choosing 48 depressed patients from sample 1 were retested for test-retest reliability with two weeks interval.ResultsThe correlation between item and the total score was significant(Ps<0.001).Three factors were produced in the exploratory factor analysis,and the cumulative contribution rate was 50.84%.Confirmatory factor analysis showed the three-factor model is better than the single-factor model(IFI=0.93,TLI=0.91,CFI=0.93,FMIN=0.76,RMSEA=0.06);The total score of CD-Quest was positively correlated with the total scores of Dysfunctional attitude scale,Negative automatic thoughts questionnaire,and Beck depression inventory-?(r=0.51,0.64,and 0.62,Ps<0.01).Reliability analysis showed that Cronbach ? coefficients of CD-Quest was 0.85,and that of 3 factors was 0.84,0.62,0.58;ICC for test-retest reliability of total scale and 3factors was 0.85,0.83,0.86,0.92.ConclusionThe Chinese-version Cognitive Distortions Questionnaire(CD-Quest)has good reliability and validity,which could be used as an effective instrument to assess the distorted cognition of Chinese depressed patients.STUDY-2ObjectiveTo study the cognitive contents of depressed patients,and compare the differences between non-depressed and normal groups;To explore the changing characteristics of cognitive content over time and the relationship between cognitive content and depression and anxiety;To explore whether the ATs and DAs are state-dependent or trait-like characteristics in patients with depressionMethodsCognitive distortions questionnaire,Dysfunctional attitudes scale,Negative automatic thoughts questionnaire,Beck depression inventory and Beck anxiety inventory were respectively supplied to 391 cases in group of depression,73 cases in group of non-depression and 108 cases of normal people;and reassed at 6 monthes interval in 107 patients with depressive episode,60 cases of patients with non-depressive episode and 108 cases of normal people,the results were analyzied by spss24.0 with general statistical description,mean comparison,Pearson correlation analysis,and single factor variance analysis,etc.Results1.The total scores of CDQ,ATQ and DAS in the baseline depression group were significantly higher than those in the non-depression group and the normal group(P < 0.05).2.AT and DA were statistically different between baseline and 6 months interval after the onset of depression.There was no significancant difference in ATQ and DAS before and after in normal group.3.Certain contents of negative automatic thoughts and dysfunctional attitudes were significantly consistent before and after follow-up: items 7,26,9 of the top 5scores were consistent in the three groups at baseline and 6 months interval;DAS at the baseline-interval repetition rate was higher in each sample.There are much difference between the different samples:in the depression group,the items22,23,21,29 were identical;Items 40,2,6,12 in the non-depression group,and entries29,35,30 in the normal group were consistent.4.Baseline-6 months interval: BDI,ATQ,DAS correlation matrix transverse analysis in depression group:(1)Baseline ATQ: Significant correlation with BDI and DAS at baseline(r=0.666,0.441;P < 0.05);significantly positively correlated with BDI and ATQ at an interval of 6 months(r=0.334,0.322;P<0.05)and no significantly correlated with DAS(r=0.060).(2)Baseline DAS:was significantly associated with BDI?ATQ(r=0.242,0.441;p<0.05);There was no significant correlation(r=0.091)with the BDI,DAS at the interval of 6 months,0.102;p>0.05),Mild correlation with ATQ(r=0.194,p<0.05).(3)ATQ at 6 months interval: BDI?ATQ?DAS at baseline ATQ was significant positive correlation with the BDI?DAS(r=0.322,0.194;0.746,0.353;p<0.05),No significant correlation with BDI(r=0.176,p>0.05).(4)DAS at 6 months interval: There was no significant positive correlation between DAS and baseline BDI,ATQ,DAS(r=0.027,p > 0.05).There was a significant positive correlation between DAS and BDI,ATQ at 6 months interval(r=0.279,0.357,P<0.05).5.Correlation analysis between ATQ,DAS,BDI and BAI at baseline and 6 months interval in depression group(1)The relationship between ATQ and BDI,BAI:At baseline:The depression group(r=0.666,0.599,p<0.05),the non-depression group(r=0.456,0.431,p<0.05),the normal group(0.293,0.262,p<0.05);At intervals of six months:The depression group(r=0.746,0.683,p<0.05),the non-depression group(r=0.721,0.541,p<0.05),the normal group(r=0.456,0.431,p<0.05);(2)The relationship between DAS and BDI,BAI:At baseline:The depression group(r=0.242,0.274,p<0.05),the non-depression group(r=0.269,0.217,p<0.05),the normal group(0.251,0.241,p<0.05);At intervals of six months:The depression group(r=0.279,0.301,p<0.05),the non-depression group(r=0.178,0.019,p<0.05),the normal group(r=0.178,-0.019,p<0.05);Conclusions1.The more obvious depression was,the more negative automatic thoughts and dysfunctional attitude were.The negative automatic thoughts was significantly higher in the remission state or mild depression state than in the normal group,and there was no statistical difference between the dysfunctional attitude and the normal group,suggesting that the dysfunctional attitude in remission state or mild depression state may be "inactivated".2.The contents of dysfunctional attitudes are consistent across time and specific to different emotional states.Dysfunctional attitudes have status-idiosyncrasies.3.The contents of negative automatic thoughts had no disease-related specificity,but was consistent across time.4.There is a high correlation between negative automatic thoughts and depression and anxiety,and the correlation between dysfunctional attitude and depression and anxiety is lower than that between negative automatic thoughts.STUDY-3ObjectiveThe functional relationship between dysfunctional attitude,negative automatic thinking and depression was discussed based on the work in front of them.MethodsOn the basis of Beck's cognitive model of depression and the developed general cognitive model,4 hypothesis models were established through multiple regression analysis and structural equation analysis for the scale data of 391 patients with depressive episode at baseline: Model 1-Etiological model,i.e.cognition is the cause of depression.Dysfunctional attitudes are activated and expressed in negative automatic thoughts,which then triggers depression;Model 2-Symptom model:Cognition exists as a symptom of depression,expressed as a variety of negative automatic thoughts after depression,and then promotes dysfunctional attitudes;Model 3-Interaction model,that means negative automatic thinking are both symptoms of depression and products of activation of dysfunctional attitudes.There is interaction between depression and dysfunctional attitudes;Based on the above model,model 4-system model was established,and it was assumed that dysfunctional attitude,negative automatic thinking and depression were correlated and caused by each other.ResultsThe path coefficients of the etiology model,symptom model and interaction model were all significant,and the model was well fitted,and the path analysis of the system model was all significant.ConclusionsA dynamic process was showed in the system of automatic thoughts,dysfunctional attitude and depression which are related in pairs and cause each other.